SAN FRANCISCO VA MEDICAL CENTERPSYCHOLOGY POSTDOCTORAL ADVANCED RESEARCH FELLOWSHIPS

TBI/Polytrauma Rehabilitation Research Fellowship2020-2022

The San Francisco VA Medical Center is recruiting for a two year Post-Doctoral Advanced Fellowship Program in the Polytrauma and Traumatic Brain Injury (TBI) Rehabilitation Research. This fellowship is funded by the Office of Academic Affiliations (OAA) Department of Veterans Affairs, and is affiliated with the University of California San Francisco.The primary goal of the fellowship is to help train clinicians and scientists (neuropsychologists, psychologists, MDs, and other allied health professionals) to become leading clinical researchers in the field of TBI / Polytrauma rehabilitation. The focus of this post-doctoral training in polytrauma and traumatic brain injury rehabilitation is to further develop clinical research expertise in the assessment and treatment of TBI, Polytrauma, and associated problems in Veterans, and to gain expertise in the advanced neuroimaging methods. The educational didactics, clinical, and clinical research training are designed to meet post-doctoral requirements for board certification in clinical neuropsychology.

Amongst the most common and debilitating consequences of mild TBI (mTBI) and psychological trauma are problems with cognition, particularly within the domains of attention, learning, working memory, and executive functioning. Veterans with these deficits experience a multitude of behavioral and functional problems, including achieving educational and occupational goals, and often report difficulty with community reintegration. Unfortunately, few effective interventions are available that target these increasingly common problems in returning Veterans, and mechanisms underlying neuroplasticity are poorly understood. The mentors of this fellowship are conducting novel neuroscience-based interventions aimed at improving cognitive control functioning, with the specific goal of promoting goal-directed behaviors in real-world contexts. Current VA Merit Awards support the implementation and refinement of

1

evidence-based neurocognitive rehabilitation for individuals suffering from cognitive difficulties associated with chronic mTBI and polytrauma. The fellow will have an opportunity to participate in a recently funded research project examining the role of advanced neuroimaging in the study of neuroplasticity associated with cognitive rehabilitation.

Fellows devote 75% of time to research and educational activities and 25% of time to clinical training. In collaboration with their mentors, fellows develop and implement a research project, present and publish their findings, and participate in grant writing. Clinical training will focus on assessment and cognitive rehabilitation of Veterans with TBI/Polytrauma.

For more information about this fellowship program please contact Dr. Tatjana Novakovic-Agopian (Tatjana.Novakovic-Agopian@va.gov)

Faculty:Tatjana Novakovic-AgopianGary AbramsJohannes RothlindPratik Mukherjee Kristine Yaffe

Medical Center Community The San Francisco VA Medical Center, or "Fort Miley," as it is known to native San Franciscans, is a nationally known teaching hospital in one of the most cosmopolitan cities in the world. Located on a hill seven miles from downtown San Francisco, the hospital overlooks the Pacific Ocean to the west and the Golden Gate Bridge to the north. The grounds cover approximately 30 acres and include 23 buildings. Each year San Francisco VA Medical Center provides Services to more than 400,000 veterans living in an eight-county area of Northern California. The Medical Center provides diagnostic and treatment services in a number of specialty areas including neurological diseases, cardiology, oncology, renal dialysis, and open heart surgery in addition to mental health treatment. The San Francisco VA Medical Center is affiliated with the University of California, San Francisco (UCSF), one of the top ranked medical schools in the country, and we train 1500 of their students in 60 professional and allied health academic programs yearly. In addition to its broader commitment to the veteran population and education, SFVAMC has the largest funded research program in the Veterans Health Administration with more than $87 million in annual research expenditures. Our Medical Center is the top-ranked VA Medical Center in terms of research grants. There are over 220 active research projects currently being conducted. Areas of particular interest are: PTSD, substance abuse, neuroscience disease, aging, oncology, hypertension, stroke, cardiovascular disease, Hepatitis C, health services research and advanced medical imaging.

SFVAMC also has the largest non-profit research foundation, Northern California Institute for Research and Education (NCIRE), also known as The Veterans Health Research Institute, which administers $54 million dollars from which indirect costs serve to enhance the VA research enterprise. The Medical Center has four Medical Science Research Enhancement Award Programs (REAP) in neurology research, prostate cancer, bone research, and rehabilitation

2

research and one HSR&D REAP in aging research. It is one of the few medical centers in the world equipped for studies using both whole-body magnetic resonance imaging (MRI) and spectroscopy, and is the site of VA’s National Center for the Imaging of Neurological Diseases. The Medical Center is fully accredited by the Joint Commission for its general medical and surgical programs as well as its psychiatry and substance abuse programs. It is approved by the American Medical Association for the training of medical students and residents in all of the major specialties and subspecialties, the Council of Teaching Hospitals of the Association of American Medical Colleges, and the West Bay Hospital Conference.

Patient Population

The San Francisco VA Medical Center serves a predominantly male population ranging in age from 18 to 90+ years, although the number of women accessing services is increasing. All racial/ethnic groups are represented and there is a large LGBT community. Patients span the spectrum of socioeconomic classes but most are considered “working class.”

Veterans do not have to have served in a war to receive benefits; however, the largest cohorts are the World War II / Korean Conflict veterans, most of whom are 65 to 90 years old, and the Vietnam Era veterans who are now in their fifties. Veterans from the Persian Gulf War (Desert Storm, Desert Shield) and the current conflicts in Iraq and Afghanistan (Operation Enduring Freedom [OEF], Operation Iraqi Freedom [OIF]) also receive health care in the VA system. Of late, particular attention has been paid to program development and special services in order to meet the needs of our returning soldiers.

Psychology Setting at SFVAMC Psychological services and psychology clinical and research training at San Francisco VA Medical Center are embedded into the Mental Health Service. The Mental Health Service teams have an interdisciplinary structure with the following disciplines represented: psychology, psychiatry, social work, nursing, internal medicine, addictions specialists.

Psychologists hold key positions in many of our specialized treatment clinics such as General Psychiatry Outpatient Clinic, PTSD Clinical Team, Substance Abuse Programs, Neuropsychological and Psychological Assessment Program, Health Psychology, Integrated Mental Health and Primary Care, Health Promotion and Disease Prevention, Women’s Clinic, Psychosocial Rehabilitation, Geropsychology, Home-based Primary Care, Suicide Prevention Team and our outlying Community-Based Outpatient Clinics in Santa Rosa and Eureka, CA.

All supervising psychologists have clinical faculty appointments in the Department of Psychiatry (Langley Porter Psychiatric Institute), University of California, San Francisco Medical School. There are currently 13 career development awardees (including four psychologists) at San Francisco VA showing the commitment of the Medical Center administration to funding trainees and young faculty members and increasing the next generation of basic and clinical scientists and VA faculty members. The clinical, teaching and scholarly achievements of our faculty are extensive.

General Breadth of Training

3

Education of current and future health care providers is one of the five missions of the San Francisco VA Medical Center. Over 650 fellows, residents, interns and students from a wide array of disciplines train here yearly. Unit based in-services are offered regularly. Since the Mental Health Service is affiliated with the Department of Psychiatry, UCSF Medical School, our staff and trainees have access to their library, colloquia, and seminars including weekly Psychiatry Grand Rounds.

The national training mission of VA is broad and explicitly includes training of health care professionals for the nation, as well as for the VA system. We train fellows who go on to VA careers, and we train others who go on to work in research, academia, other medical centers, and the private sector. A number of our own postdoctoral fellows have recently gone on to obtain positions in VA careers, both here and at other facilities.

Psychology Research Fellowship Program Structure The psychology research fellows train in the clinic(s) or programs associated with their research fellowships. They receive supervision from the psychologists, medical educators, and other clinical investigators leading those research studies and clinics. The research fellows are primarily involved in research activities (~75% time) and can allot up to 25 percent of their time to educational, clinical, and administrative activities. As fellows move from Year 1 to Year 2, they progress from projects designed by their mentor to a more independently conceived project, which they lead. There are additional opportunities for training in clinical supervision, leadership, and program development. The fellows also participate in didactic training designed to facilitate research design and implementation skills, including seminars, grand rounds, and journal clubs.

Psychology Research Fellowship Goals: At the end of Psychology Research Fellowships, we expect fellows to have acquired the following competencies and completed the following tasks:

gained knowledge of their designated content area of scientific inquiry advanced their knowledge of statistical and methodological techniques needed for

research in their area of interest understand empirical research projects in their area of interest conducted at least two research projects: One designed by their preceptor; and one of

their own design, for which they have primary responsibility made multiple internal presentations made at least two presentations of their work at national meetings published one to three journal articles submitted a small grant application to local funding sources published additional publications from the work completed as a scholar during the two

years following enrollment in our program

In keeping with our philosophy that postdoctoral fellows are considered “junior colleagues,” fellows are invited to attend the Psychology Faculty Meeting chaired by Dr. Jennifer Boyd, Chief Psychologist, which meets 2-3 times per month. The agenda for this meeting focuses on issues current psychologists on staff are facing. Fellows have ample opportunities to participate in program development and take active leadership roles. All fellows have the opportunity to

4

conduct an administrative project during the year. Examples of such are Externship Coordinator, Quality Improvement Projects, organizing training seminars, etc.

Facility and Training Resources Fellows will have their own workspace with lockable cabinets, drawers, their own computer and telephone line with private extension number. They may have their own offices or work stations. Fellows carry VA issued pagers and are not expected to use their own resources such as cell-phones, flash drives or recording equipment. Fellows have access to program support, medical library at the VA as well as use of UCSF library and other resources. Clinical space is provided through a room check-out procedure if necessary. Each VA computer has access to the Internet and on-line literature search resources as well as word processing and CPRS medical record keeping. There is a broad range of psychological and neuropsychological tests available. Clerical support is available through each clinic as well as through Psychological Services. The SFVAMC Medical Library has over 350 current journal subscriptions, 43 of which are mental health related. Medline and Psych Info searches are provided through the library, as are numerous other resources. Fellows also have access to the medical library of UCSF, with its 2,600 current journals and Center for Knowledge Management services.

Supervision and State LicensureFellows receive supervision from supervisors/mentors in their area of interest. Some research fellowships may wish to pursue state licensure. Requirements for state licensure differ from state to state. Ways of achieving eligibility for licensure for fellows wishing to pursue this option are planned and arranged with the primary supervisor/mentor for those fellowships. Licensure in the state of California requires at least four hours of regularly scheduled supervision per week with a minimum of two supervisors, at least two of which are individual supervision. Supervision and evaluation methods include self-report of clinical work, supervision sessions, live observation of client and/or staff interactions; review and co-signature of all written material such as progress notes or other additions to the computerized patient record system; observation of case formulation and case presentation in staff meetings, treatment planning conferences, and other multidisciplinary settings; review of process notes, audiotape recording and/or videotape recording of psychotherapy and assessment sessions; and the review of psychological testing protocols and reports. Fellows should expect to be assigned readings and literature reviews as part of their supervision.

Evaluations Fellows are formally evaluated at regular intervals to guide and determine progress in achieving fellowship goals and competencies. Evaluations are discussed with fellows and may be modified by mutual agreement before being placed in the training files. Fellows also are asked to evaluate their supervisors at each evaluation period, and an exit interview is completed at the end of fellowship to solicit feedback and suggestions for the program going forward. Selection ProcessCompleted applications are reviewed by the supervisors of each research fellowship. Application ratings are based on the applicant's interest, experience and quality of previous clinical training in the area of emphasis, academic work and accomplishments, letters of recommendation, personal qualities of the applicant (maturity, ethics, responsibility, insight, etc.)

5

and written material. Ultimately, our selection criteria are based on a "goodness–of–fit" and we look for fellows whose experience and career goals match the research training that we offer.

Training Term The research fellowships are full-time, two-year, 52 week commitments (2080 hours per year). Research fellows are entitled to 10 federal holidays and earn sick leave and vacation (annual leave) days at a rate of 4 hours of each per two- week pay period (a total of 13 days of each). San Francisco VA also offers generous professional leave for conferences and other approved educational activities. Some fellowships can extend to a third year. Requirements for state licensure as a professional psychologist can be met within some of our research fellowships.

Stipend and Benefits The current stipend is $55,565 for the first year. State and federal income tax and FICA are withheld from Fellows' checks. Fellows are not covered by Civil Service retirement or leave and are not eligible for federal life insurance benefits. The United States Government covers fellows for malpractice under the Federal Tort Claims Act. VA offers individual and family health insurance plans for fellows on a matching basis, (i.e., fellows pay half of the premium and the VA pays the other half.) On June 26, 2013, the Supreme Court ruled that Section 3 of the Defense of Marriage Act (DOMA) is unconstitutional. As a result of this decision, the Office of Personnel Management (OPM) has now extended benefits to employees and annuitants who have legally married a spouse of the same sex. Dental and vision insurance are also available. San Francisco VA Medical Center also offers a public transportation reimbursement program. Fellows are entitled to 10 federal holidays and earn sick leave and vacation (annual leave) days at a rate of 4 hours of each per two-week pay period (a total of 13 days of each). San Francisco VA also offers professional leave for conferences and other approved educational activities.

Application & Selection Procedures

Eligibility Candidates MUST be graduates of APA-accredited doctoral programs in clinical or counseling psychology and MUST have completed an APA-accredited internship. All requirements for the doctoral degree must be completed prior to the start of the fellowship year. Persons with a Ph.D. in another area of psychology who meet the APA criteria for respecialization training in Clinical or Counseling Psychology are also eligible. The VA requires that applicants are US Citizens, men have registered for selective service, and all have had varicella infection (“chicken pox”) or vaccination for such prior to the start of the fellowship. Specific details related to eligibility: 1. U.S. citizenship. VA is unable to consider applications from anyone who is not currently a

U.S. citizen. Verification of citizenship is required following selection. All interns and fellows must complete a Certification of Citizenship in the United States prior to beginning VA training.

2. Fellows are subject to fingerprinting and background checks. Match result and selection decisions are contingent on passing these screens.

6

3. VA conducts drug screening exams on randomly selected personnel as well as new employees. Interns and Fellows are not required to be tested prior to beginning work, but once on staff they are subject to random selection for testing as are other employees.

4. Have received a Doctorate from an APA-accredited graduate program in Clinical or Counseling Psychology. Persons with a doctorate in another area of psychology who meet the APA criteria for respecialization training in Clinical or Counseling Psychology are also eligible.

5. Have completed an internship program accredited by the APA Commission on Accreditation or have completed a VA- sponsored internship.

Application Procedure To apply for our one of these postdoctoral research fellowships, please submit application materials listed below to Dr. Tatjana Novakovic-Agopian. Application review will start on 12/30/2019 and continue until position is filled. Please do not mail any materials in hard copy form. 1. Letter of interest, including a brief summary of educational, research, and clinical research

experiences relevant to the fellowship, a summary of your training needs and goals, and a statement of your career goals.

2. Current Curriculum Vitae 3. Three letters of Recommendation 4. A letter of support from your Dissertation chairperson describing your dissertation status and

timeline if you have not completed your graduate degree. Dissertations must be complete before the postdoctoral fellowship begins. Please note we will be monitoring dissertation progress and status on a routine basis. All requirements for the doctoral degree must be completed prior to the start of the fellowship year.

5. A letter of support from your current Internship Training Director indicating that you are in good standing to successfully complete your predoctoral internship, including the expected completion date. If internship already completed, you can mail a copy of your predoctoral internship certificate.

Contact Information Specific questions may be directed to Dr. Tatjana Novakovic-Agopian (Tatjana.Novakovic-Agopian@va.gov). Administrative contact is Roger Brown (Roger.Brown@va.gov)

Other Information The San Francisco VA’s Psychology Research Fellowship Program is affiliated with the University of California, San Francisco. In accord with the Federal Drug-Free Workplace Program, fellows may be subject to urine testing for illicit drug use. Other branches of the federal government (Office of Personnel Management) may conduct routine background checks at their discretion.

The San Francisco VAMC is an Affirmative Action/Equal Opportunity Employer. All qualified applicants are encouraged to apply, including minorities and women. VA seeks candidates whose experience, teaching, research, or community service has prepared them to contribute to our commitment to diversity and excellence.

7

8